Sunday, July 20, 2008

Sometimes the hardest thing is to be suffering from nothing at all-or rather, no disease that fits into a category defined by mainstream medicine. Tortured by low back pain, headaches, fatigue, nausea, gas, bloating, constant sinus infections, and poor concentration, Nicole saw her whole life going downhill. But as far as modern medicine was concerned, she suffered from no diagnoseable condition. Tests for systemic lupus, arthritis, and immune system deficiency all came back negative. Finally, Nicole insisted on getting a test for candida yeast overgrowth. The test came back positive.

"Once I started treatment for candida infection, it was like night and day. After three weeks I woke up one morning and for the first time since I got sick, I didn't have any pain," Nicole recalls. "Over the next few weeks, all my symptoms cleared up. Before I could barely walk a mile, now I spend weekends on 15-mile hikes with my friends. As long as I'm careful not to do things that cause the problem to recur, I'm completely fine."

Candida albicans is a type of yeast, a single-celled organism that lives on the surfaces of living things. In humans it lives in the intestinal tract and in the vagina, normally in peaceful co-existence with the human organism. If the immune system gets weakened, however, candida sometimes will proliferate out of control, resulting in a condition also known as candidiasis. Like any microbial invasion, an infection with candida can wreak havoc with many physiological functions. Candidia albicans is responsible for 80 to 90 percent of vaginal yeast infections.

Mainstream medicine generally considers candida infection a threat only to people with severely compromised immune function, such as AIDS patients or people undergoing chemotherapy. A growing number of medical practitioners, however, are arguing that candida overgrowth also can become a problem for otherwise healthy people whose immune systems have been weakened for one reason or other. One of the first medical doctors to argue that candidiasis is a much more widespread and debilitating syndrome than generally acknowledged was Dr. William Crook, who brought the candida problem to national attention with his book The Yeast Connection (Vintage Books, 1986). Dr. Crook and many other medical practitioners like him link candida overgrowth to an astonishing range of ailments-from general fatigue and mood afflictions, to gastrointestinal dysfunction, skin disorders, infectious diseases, problems of the reproductive organs, and problems with the muscular and nervous systems. The candida syndrome is associated with such a wide range of disorders, because when yeast proliferates in the gut and in other parts of the body, it creates numerous harmful effects. Candida puts out 79 different toxins, which weaken the immune system and cause many of the symptoms associated with candidiasis.

Candida overgrowth in the intestines is also thought to be associated with the so-called 'leaky gut' syndrome, in which intestinal permeability increases, causing toxins and food particles to pass directly into the body. These can wreak havoc with the immune system, as it is forced to deal with these normally harmless molecules. Many symptoms may also be created by allergic reactions when the yeast organisms proliferate.

Locating A Cause

What causes candida to multiply out of control? Prolonged or repeated courses of antibiotics appear to be one of the most common triggers. Antibiotics eradicate the friendly intestinal flora that help to keep the yeast in check, while leaving candida unharmed and free to proliferate. And once candida starts to multiply, the fungus overgrowth puts out toxins that further weaken the immune system. The result is often a vicious cycle of recurring infections and repeated courses of antibiotics, which can have debilitating effects on the body as a whole.

Other drugs that can lead to unchecked candida growth include birth control pills, steroids, antacids, and anti-ulcer medications. Women are often more susceptible to candida attacks, because the hormonal changes associated with the menstrual cycle and pregnancy create environments more conducive to candida growth.

One of the problems in accumulating medical research on the candida syndrome is that the condition can be very difficult to diagnose. First of all, as in Nicole's case, a candida infection is often accompanied by many diverse and seemingly unrelated symptoms. Secondly, there has been no reliable test to diagnose the problem; blood, stool, or saliva tests are notoriously unreliable. As a result, medical practitioners are forced to base their diagnosis on the patient's medical history, or they may make a therapeutic test, putting the patient on a short-term treatment plan to see if symptoms improve.

"There are some main categories of symptoms that always make me suspect candidiasis," says Angela Heine, N.D., a naturopath in Woodenville, Washington. "If the person suffers from any three of five factors-recurrent vaginal yeast infections, chronic sinus congestion, foot fungus, sugar cravings, or fatigue-I'll start to look for other things to confirm the diagnosis. If there's also abdominal distention or maldigestion, gas, or increased belching after meals, the picture starts to become pretty clear. Then I look for a history of taking antibiotics, oral birth control pills, or other substances that can trigger candidiasis."

In recent years, some medical practitioners have started to rely on a test, that measures the presence of candida immune complexes in the blood, in making their final diagnosis of candida overgrowth. Studies have shown that abnormally high levels of candida antibodies in the blood are closely correlated with the clinical symptoms of candidiasis. Heine estimates that 80 percent of the patients she refers to this test, based on their symptoms and medical history, come up positive on the antibody test.

Anti-Yeast Remedies

Dr. Heine recommends a number of non-prescription anti-yeast agents that can be used to enhance the effects of Dr. Crook's diet. These are especially useful if your candida infection is relatively mild and your symptoms are of recent origin. In most cases, one or a combination of these anti-fungal remedies together with the diet can help curb the problem. If your yeast condition is more severe, however, talk to your doctor about getting a prescription for an anti-fungal drug, such as nystatin or diflucon.

You also need to focus on strengthening your immune system and the overall nutritional balance of your body. This can easily be done with supplements. However, taking supplements should not be an excuse for slacking on your diet; eating a healthy, well-balanced diet is one of the key factors in restoring your body to health. Some immunity-building supplements include:

Garlic-a commonly recommended remedy both in its natural form and as a supplement. Garlic greatly enhances the activity of white blood cells and has many other medicinal benefits.

Coenzyme Q10-a vitamin-like substance that is essential for the production of cellular energy; an antioxidant.

Vitamins C and E and beta carotene-are all powerful antioxidants.

Multi-vitamin complex-to ensure that you get the minimum daily doses of the vitamins and minerals you need during this important time of healing.

Some people with a long-term chronic candida problem find that symptoms return when they go off the diet and anti-fungal remedies. In such cases, there might be underlying conditions that permanently weaken the immune function and disable the body's ability to keep candida in check. Some medical practitioners suggest that such cases of chronic candidiasis often are caused by an underlying intestinal parasite infection.

The Road to Health

Candida overgrowth is a problem that is best addressed in its early stages. Once it becomes more deep-rooted and has started to wreak physiological havoc, it can be much harder to return the body to health. If you suspect you may suffer from candidiasis, work with a physician who can make a conclusive diagnosis and help you develop a proper treatment plan. Because the candida syndrome still is relegated to a gray area somewhere between mainstream and alternative medicine, your regular provider might not know enough about the condition to help you. The Resource section on the last page suggests ways to find a medical practitioner that can help.

The following general guidelines for dealing with candida will also be helpful, but it is not a complete treatment plan. You will still need to work with a qualified doctor, who can develop a plan suited for your unique condition and monitor your progress.

Guidelines for Treatment

Candidiasis is a complex syndrome, and medicine alone is not enough to overcome the problem. If you take anti-fungal remedies but continue to eat a diet rich in sugar and other nutrients that the yeast can feed on, it will bounce right back. There are an awful lot of foods that encourage yeast growth, and eliminating these from your diet is an important part of treatment.

Dr. Crook recommends completely avoiding sugar-containing products and sugar in all forms; foods that contain vinegar, yeasts, or molds, and foods that contain simple carbohydrates, such as white flour products, junk food, and ready-to-eat cereals. He also recommends eliminating fruits, because these are high in sugar. Fruit juices especially are often made from fruits harvested so long ago that some of them have become overgrown with mold or fungus. Instead, emphasize vegetables low in carbohydrates and high-protein foods, such as tofu, nuts, and legumes. It is very important to adhere very strictly to the diet the first 3 to 4 weeks of the treatment. After this, you can gradually start to introduce some foods and see how they affect you.

When the yeast starts to die off, it emits toxins, which often cause symptoms to worsen. This is a temporary response known as the 'die-off' reaction, and it is a positive sign that the treatment is working. If you start taking anti-fungal remedies at the same time as you start your diet, the die-off reaction could be quite strong. To minimize the die-off reaction, Dr. Crook recommends that you start the diet one week before taking any anti-fungal remedies (see sidebar, left), so that the yeast dies off more gradually.

It's important to note, however, that despite the popularity of Dr. Crook's book, his diet and treatment recommendations are still considered to be experimental by the American Academy of Allergy, Asthma, and Immunology who cite Dr. Crook's concept of Candidiasis Hypersensitivity Syndrome as speculative and unproven.

This is largely due to the wide variety of symptoms attributed to the syndrome and current lack of conclusive scientific evidence that Candidia albicans is directly responsible for the syndrome, or that the recommended restricted diet, immunotherapy, and antifungal agents are beneficial.

More studies are needed. But improving one's diet, cutting back on sugar, and taking acidolphilus has been recommended by many doctors for women suffering from reoccurring yeast infections with positive results.

Lastly, remember that regaining and maintaining health involves all areas of life. Candida is an early warning sign that the body's inherent defenses have been weakened. To further strengthen your body, you have to make sure that your lifestyle supports, rather than undermines, your health. Minimize your exposure to environmental chemicals, exercise regularly, don't overwork, practice a meditation or a relaxation technique to reduce stress, and most importantly, focus on things that make you happy. By heeding the body's early warning signals, you can prevent more serious problems from developing down the road.